Opinion 2: Health Care Reform Law Demands Transparency
But the long-term success of the law requires that we control rising health care costs, which threaten to undermine the gains of the past year by saddling individuals, businesses and the state with a crushing financial burden. In the past four years alone, health care costs have increased by one third.
Controlling costs is acutely important to those individuals and small businesses in the Worcester area who are mandated by law to purchase health insurance under the new law.
Earlier this month, Fallon Community Health Plan and other members of the Massachusetts Association of Health Plans proposed a series of steps and measures that we hope will focus everyone involved in health care policy on controlling costs.
Our proposal is based on the notion that controlling costs begins with illuminating them. It grew from an idea put forward by Senate President Therese Murray to hold public hearings on any insurance premium increase above 7 percent. The health plans' proposal calls for:
• Annual public hearings on health care costs. We believe health plans should participate in public hearings, no matter how much their premium increases. Because insurance premiums simply reflect health care costs, we also believe that providers - hospitals, health centers, physician practices and pharmacies - should participate as well. This forum will allow policymakers to better understand what factors or combination of factors - greater utilization of technology, increased consumer demand, higher reimbursement rates, etc. - are driving up costs.
• Public reporting of health care revenues and expenses. The health plans are not even waiting for hearings to begin disclosing financial information. Health plans have already begun voluntarily disclosing data such as total revenues, administrative costs and medical costs in a consumer-friendly format on the Internet (http://www.mahp.com/news/costcontrol.html). Again, since health plan costs are driven by charges from providers, we have urged them to join us in making these voluntary disclosures. All of this information is already filed with the state, but it is difficult to find. We believe that making this information easily accessible to everyone is the first step in controlling costs.
• A public forum to find good ideas. The health plans recognize that we don't have all the answers. We also understand that better utilizing existing resources and having a real impact on costs will require cooperation across the health care system. For that reason, we are suggesting that everyone involved in health care - health plans, providers, employers, consumer organizations and state policymakers - come together in a series of forums designed to identify and develop additional measures that would control costs while maintaining or improving quality.
The late Supreme Court Justice Louis Brandeis famously said, "Sunlight is said to be the best of disinfectants." He was taking a medical adage of his time and applying it to public debate. It's time to apply Brandeis' words back to our health care system.
Eric H. Schultz is president and CEO of Worcester-based Fallon Community Health Plan, and vice chairman of the Massachusetts Association of Health Plans.
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